NPI | 1154771970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382650) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 641639) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2021-05-11 |